Letter to the Prime Minister

The Rt Hon Boris Johnson MP
Prime Minister
10 Downing Street
London
W1A 2AA

29 June 2020

Dear Prime Minister

Many of us represent organisations or are individuals who are at the forefront of the current Covid-19 crisis. We believe urgent action is needed to improve health outcomes and support the most vulnerable people who are at most risk of needless death and cold related morbidity this winter. We are therefore writing to call on you to follow through with your welcome proposals in your manifesto and Queens Speech to invest in warmer and healthier homes1.

You know from your own experience the critical importance of beating this virus and of a living environment which gives people that are ill the best possible chance of recovery. Whilst the current crisis has so far taken place in the warmer months, millions of people across the country will be dreading this coming winter. The health implications of cold temperatures on respiratory conditions2 and on frail and elderly households are well known. These impacts are also intergenerational3, with children twice as likely to suffer from asthma or bronchitis if they inhabit cold and damp housing4.

During the colder months many people will continue to stay at home for longer periods. Alongside the psychological stress and social isolation caused by the virus, too many will have to choose between heating their home adequately and falling into debt or rationing their energy use and living in cold damp homes that are dangerous to their health and can shorten their lives. This can lead to a vicious cycle of hospital admission, discharge and readmission. Even before the current crisis, the economic burden of this ‘carousel of morbidity’ cost the NHS between £1.4 and £2.0 billion every year5. A second Covid-19 wave during a cold spell this winter could be catastrophic for individuals, families and overwhelm our health and social care services.

A key preventable factor is the UK’s building stock which remains notoriously inefficient and hard to heat. Millions face this winter in properties which are dangerous or unfit for colder seasons. Poor housing leads to sharp rises in energy use.6 A recent independent analysis suggests that, if a second lockdown was re-imposed during winter months, families in cold, leaky homes would face heating bills elevated on average to £124 per month, compared with £76 per month for those in well-insulated homes – a difference of £49 (£48.7) per month7.

Despite welcome proposals in your manifesto and Queens Speech to help improve this situation, recent Government statistics highlight energy efficiency delivery has dropped dramatically since 20128 and one in ten households in England live in fuel poverty, meaning they live below the poverty line but also have much higher bills due to poor levels of energy efficiency9 . As lockdown begins to ease and you consider our economic recovery plan, you can address those preventable factors that aggravate respiratory illnesses and create or exacerbate other serious health conditions. By kick-starting a nationwide home and public sector energy efficiency retrofitting programme – starting with fuel poor households and social housing – you can directly save lives.

Such a programme will put people back to work10 , address regional variances in economic deprivation and provide a major stimulus to the economy11 . These actions would also help to provide active referrals to many existing health and housing schemes12 , reduce poor air quality which also damages respiratory health and reduce carbon emissions to make a direct contribution to meeting the UK Government’s goal of becoming net zero.

The recurrent crisis of early death and ill health caused by cold homes will not abate by itself. We call upon you to take actions that will prevent such a crisis, stimulate the economy and build back better.


  1. The Conservative manifesto and Queens Speech committed to investing an £9.2 billion in the energy efficiency of homes, schools and hospitals; £3.8 billion over ten years for a Social Housing Decarbonisation Fund, £2.5 billion over five years to 2025 for Home Upgrade Grants for support deep renovation for low income households living in highly inefficient homes and £2.9 billion over five years to 2025 for a Public Sector Decarbonisation Scheme. This amounts to an additional investment, over and above current policies, of £2.9 billion over the next two years.
  2. Public Health England (PHE), 2015. The National Institute for Health and Care Excellence (NICE) have also produced related guidelines on reducing the risk of the impact of cold homes which has been supported by many independent health institutions.
  3. Age-specific mortality rate per 100,000 people, Number of deaths registered each month in England and Wales, including deaths involving the coronavirus (COVID-19), by age, sex and region, ONS.
  4. Friends of the Earth and Marmot, 2011
  5. BRE (2015) The cost of poor housing to the NHS. [Online]. Available from: https://www.bre.co.uk/filelibrary/pdf/87741-Cost-of-Poor-Housing-Briefing-Paper-v3.pdf [Accessed: 21 June 2019].
  6. Emissions from homes and public buildings rose sharply by 2.5m tonnes or 4% in 2018 as a result of the Siberian weather system ‘the Beast from the East” equivalent of a small country’s like Albania’s annual emissions.
  7. Lockdown in Leaky Homes, The Energy and Climate Intelligence Unit, 22 May 2020.
  8. Business, Energy and Industrial Strategy Committee Energy efficiency: building towards net zero Twenty-First Report of Session 2017–19 Report, together with formal minutes relating to the report Ordered by the House of Commons to be printed 9 July 2019, page 23.
  9. Annual fuel poverty statistics report for 2020 (with 2018 data), Department for Business, Energy & Industrial Strategy, 30 April 2020
  10. According to Bank of England forecasts, unemployment is likely to increase by an additional 1.79m people by the end of 2020.
  11. Rebuilding for resilience, Energy efficiency’s offer for a net zero compatible stimulus and recovery, Energy Efficiency Infrastructure Group (EEIG), June 2020
  12. NEA has catalogued health and housing schemes which deliver energy efficiency improvements through LA’s and the health sector which have had success in addressing and/or stabilising related health conditions, see: https://www.nea.org.uk/wp-content/uploads/2019/10/Catalogue-of-Health-Related-Fuel-Poverty-Schemes-2019.pdf.

SIGNED BY

Health professionals

  • Professor Maggie Rae, President, Faculty of Public Health
  • Dr Jessica Allen, Deputy Director, UCL Institute of Health Equity Medact
  • Ivan Browne, Director Public Health at Leicester City Council
  • Dr Caroline Dimond, Director of Public Health, Torbay Council
  • Rachel Wigglesworth, Director of Public Health Cornwall Council
  • John Middleton, Honorary Professor of Public Health, Wolverhampton
  • Rob Howard, Consultant in Public Health and Head of School: Health Education East Midlands – Public Health
  • Sarah Muckle, Director of Public Health, City of Bradford Metropolitan District Council
  • Teresa Roche, Director of Public Health, Rotherham Metropolitan Borough Council
  • Dr Rupert Suckling, Director of Public Health, Doncaster
  • Professor Dominic Harrison, Director of Public Health and Wellbeing, Blackburn with Darwen Borough Council
  • Dean Wallace, Director of Public Health, Derbyshire County Council
  • Ruth Harrell, Director of Public Health, Plymouth
  • Rachel Flowers, Director of Public Health, Croydon
  • Miriam Davidson, Director of Public Health, Darlington Borough Council
  • Catherine Mbemba, Lewisham’s Director of Public Health
  • Kate Blackburn, interim Director of Public Health for Wiltshire Council
  • Julia Burrows, Director of Public Health, Barnsley Metropolitan Borough Council
  • James Szymankiewicz, GP
  • Chris Newman, GP, London
  • Jonathan Groome, Anaesthetist, London
  • Rosa Roberts, Psychiatry CT, Bristol
  • Rita Issa, GP registrar, London
  • Tracy Lyons, Pharmacist, Bournemouth
  • Peter Labib, Surgical registrar, Plymouth
  • Mangala Patil Mead, Occupational Medicine, consultant St Albans
  • Finola ONeill, GP
  • Deirdre Watters, GP, Liverpool
  • Kirsten Shukla, Psychiatrist
  • Susan Myint, GP, Ealing
  • João Martins, GP registrar, Oxford
  • Hannah Short, GP, Newmarket
  • Shireen Kassam, Consultant Haematologist, London
  • Issabella Beale, GP, Dorset
  • Olivia Davies, Registrar in Geriatrics, Poole
  • Nadia Audhali, GP Rebecca Hall, GP, Frome
  • Stefan McKenzie, Psychiatry Trainee, Sheffield
  • Helena Clements, Consultant Paediatrician, Nottinghamshire
  • Andrew Boyd, GP, London
  • Juliette Brown, Consultant Psychiatrist, London
  • Eliot Waterhouse, Emergency Medicine Trainee, Sheffield
  • Elmer van der Hoek, GP Locum, Colchester/ London
  • Jonathan Fluxman, GP (ret)
  • Eleanor Cooke, Psychiatry trainee
  • Robert Johnstone, Clinical Scientist, London
  • Dominic Nee, Neurology registrar, Brighton
  • Miranda Cole, Medical registrar, Bristol
  • Lynne Jones, Consultant child and adolescent psychiatrist, Cornwall
  • Asmamaw Sisay Yigeremu, GP
  • Cordelia Howitt, Consultant histopathologist, Stoke on Trent
  • Harriet Roberts, GP Registrar, Exeter
  • Thomas Downs, Foundation Doctor, Bangor
  • Anne Hayden, GP (Ret)
  • Hattie Nicholas, Clinical Education Fellow, Bristol
  • Jasmine Schulkind, Junior Doctor (F4 locum stroke medicine)
  • Alistair Wardrope, Neurology trainee, Sheffield
  • Sophie Williams, Oncology trainee, Sheffield
  • Jonathan Monk-Cunliffe, Junior Doctor, Bristol
  • Dilys Noble ,GP ret, Sheffield
  • Sian Ashby, GP ,Glasgow
  • Claire Gaughan, GP
  • Francine Martin, GP, Glasgow
  • Gordon Black, GP
  • David Stewart, GP ,Glasgow
  • Neil Calderwood, Junior doctor
  • Sarah Briggs, Oncology Registrar, Oxford
  • Simon Kaye, GP Cumbria
  • Ruth Arnold, GP, Poole
  • Margaret Jackson, GP, Yorkshire
  • Naomi Adelson, GP, Birmingham

Elected officials

  • Peter Taylor, Elected Mayor of Watford
  • Cllr Denise Jeffery, Leader of Wakefield Council and Chair of Cabinet
  • Cllr Jonathan Slater, Lewisham Council Cabinet Member for the Community Sector
  • Cllr Paulette Lappin, Sefton Council
  • Cllr Mulherin, Leeds City Council
  • Cllr Jeanie Bell, Cabinet Member for Community Safety, St Helens Borough Council

Housing and energy sector

  • Adam Scorer, Chief Executive, National Energy Action (NEA)
  • Tracy Harrison, Chief Executive, Northern Housing Consortium
  • Sue Adams, CEO, Care and Repair England
  • Jim Watson, Professor of Energy Policy Research Director, UCL Institute of Sustainable Resources
  • Jacky Peacock OBE, Director, Advice for Renters
  • Angela Gascoigne, CEO, SHAL
  • Andrew Harrison, Broad Oak Properties Ltd
  • Raymond Osborne, MD, Osborne EnergyAndrew Scotter, Borthwick Heating Insulation UK LTD
  • Gearóid Lane, Agility ECO
  • Martin O’Brien, Association of Local Energy Officers, London
  • Hardial Bhogal, CEO, Area Eco
  • Graham Edwards, Chief Operating Officer, Wales & West Utilities
  • Gill Wyatt, Exeter Community Energy
  • Georgina Sommerville, Director, Green Rose CIC
  • Duncan McCombie, Group CEO – YES Energy Services CIC
  • Erik Coates, Energy Services Director, Pacifica Group
  • Matt Neal, National Energy Foundation
  • Jim Lynch, Commercial Director, Northern Gas Heating Limited
  • Frazer Scott, Chief Executive Officer, Energy Action Scotland
  • Dr Tim Jones, Chief Executive, Community Energy Plus
  • Guy Pulham, CEO, UK & Ireland Fuel Distributors Association
  • Rachel Jones, Chief Executive, Act on Energy and Chair of West Midlands Association of Local Energy Officers
  • Ian Henderson, Managing Director, Boiler Plan UK
  • Dr. Simone Lowthe-Thomas, Severn Wye Energy Agency
  • Jonathan Cosson, Director, Cyfarwyddwr, Warm Wales Cymru Gynnes CBC
  • Matthew Cole, Chair of Trustees, Fuel Bank Foundation
  • Emily Thompson, Director of Climate Change & Fuel Poverty, Groundwork in the North
  • Simon Kilshaw, Green Doctor Manager, Groundwork North, East & West Yorkshire
  • Stuart Dawks, CEO, PECT
  • Sue Painting, Chair of The Footprint Trust Paul Stapleton, Managing Director, NIE Networks Tom Bell, Head of Social Strategy,
  • Northern Gas Networks Anton Humphrey, Retrofit Works
  • Mark Randall, Managing Director, Aran Services
  • Fiona Price, Melin Homes
  • Phil Hurley, Managing Director, NIBE Energy
  • Dr Mark Fishpool, Director, Middlesbrough Environment City

Local Citizen Advice organisations

  • Carol Shreeve CEO, Citizens Advice Mid-North Yorkshire
  • Lesley Powell, CEO, Citizens Advice Denbighshire
  • David Harper, CEO, Citizens Advice Reading
  • AbI Conway, CEO, Citizens Advice Northumberland
  • Helen Goldsack CEO, Purbeck Citizens Advice
  • Stuart Dexter, CEO, Citizens Advice County Durham
  • Liz de Villiers, CEO, Citizens Advice Tunbridge Wells & District
  • Angela Newey, CEO Citizens Advice in North & West Kent
  • Caroline Jones, CEO, Citizens Advice Calderdale
  • Janie Moor, CEO, Citizens Advice South Hams
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